Rhabdomyosarcoma surgery: Difference between revisions
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! style="background: #4682B4; color:#FFF;" | Symptoms | ! style="background: #4682B4; color:#FFF;" | Symptoms | ||
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| style="padding: 5px 5px; background: #e4e4e4;" | Head and neck | | style="padding: 5px 5px; background: #e4e4e4;" | Head and neck<ref name="pmid10772299">{{cite journal| author=Daya H, Chan HS, Sirkin W, Forte V| title=Pediatric rhabdomyosarcoma of the head and neck: is there a place for surgical management? | journal=Arch Otolaryngol Head Neck Surg | year= 2000 | volume= 126 | issue= 4 | pages= 468-72 | pmid=10772299 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10772299 }}</ref> | ||
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* Due to cosmetic concerns, wide local excision is not capable. | * Due to cosmetic concerns, wide local excision is not capable. | ||
* Cervical lymph node assessment is not essential. | * Cervical lymph node assessment is not essential. | ||
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| style="padding: 5px 5px; background: #e4e4e4;" | | | style="padding: 5px 5px; background: #e4e4e4;" | Extremities<ref name="pmid10693687">{{cite journal| author=Neville HL, Andrassy RJ, Lobe TE, Bagwell CE, Anderson JR, Womer RB et al.| title=Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdomyosarcoma Study IV (1991-1997). | journal=J Pediatr Surg | year= 2000 | volume= 35 | issue= 2 | pages= 317-21 | pmid=10693687 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10693687 }}</ref> | ||
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|- | * Tumor resection should be performed with maintaining extremity function. | ||
| | * Sentinal lymph node biopsy is required. | ||
| style="padding: 5px 5px; background: #e4e4e4;" | | * In perineal and anal rhabdomyosarcoma, ilioinguinal lymphadenectomy is required. | ||
* In cases with positive margin, re-excision must be done for evaluation. | |||
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| style="padding: 5px 5px; background: #e4e4e4;" | Abdomen or pelvis | | style="padding: 5px 5px; background: #e4e4e4;" | Abdomen or pelvis | ||
Revision as of 17:10, 15 February 2019
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Rhabdomyosarcoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Rhabdomyosarcoma surgery On the Web |
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American Roentgen Ray Society Images of Rhabdomyosarcoma surgery |
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Risk calculators and risk factors for Rhabdomyosarcoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Surgical resection of the rhabdomyosarcoma is often difficult or impossible because the tumor is usually embedded deep within the tissue, leaving it difficult to reach.
Surgery
- Primary resection of tumor is one of the main prognostic factors in rhabdomyosarcoma.[1][2]
- Based on tumor;s location, surgical resection may be different.
- Findings of surgical resection is essential for risk stratification.
- Surgical tumor resection must contain complete tumor removal with performing safe margin resection.
- Although recommended safety margin is 2 cm, it is impossible to perform in children because of tissue limitation.[3]
- Several biopsies are needed in case of narrow margins to identify residual disease.
- If surgical excision could not be performed, 12 weeks chemotherapy is recommended.
- Lymph nodes need to be assessed for further evaluation.
- In extremities of rhabdomyosarcma, axillary and femoral lymph nodes should be assessed.
| Location | Symptoms |
|---|---|
| Head and neck[4] |
|
| Extremities[5] |
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| Abdomen or pelvis | Neoadjvant therapy with chemotherapy and radiotherapy; wide local excision |
| Paratesticular region | Removal of testes and spermatic cord; ipsilateral retroperitoneal lymphnode resection |
References
- ↑ Schalow EL, Broecker BH (2003). "Role of surgery in children with rhabdomyosarcoma". Med Pediatr Oncol. 41 (1): 1–6. doi:10.1002/mpo.10261. PMID 12764734.
- ↑ PDQ Pediatric Treatment Editorial Board. Childhood Rhabdomyosarcoma Treatment (PDQ®): Health Professional Version. 2019 Jan 29. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65802/
- ↑ Dasgupta R, Fuchs J, Rodeberg D (2016). "Rhabdomyosarcoma". Semin Pediatr Surg. 25 (5): 276–283. doi:10.1053/j.sempedsurg.2016.09.011. PMID 27955730.
- ↑ Daya H, Chan HS, Sirkin W, Forte V (2000). "Pediatric rhabdomyosarcoma of the head and neck: is there a place for surgical management?". Arch Otolaryngol Head Neck Surg. 126 (4): 468–72. PMID 10772299.
- ↑ Neville HL, Andrassy RJ, Lobe TE, Bagwell CE, Anderson JR, Womer RB; et al. (2000). "Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdomyosarcoma Study IV (1991-1997)". J Pediatr Surg. 35 (2): 317–21. PMID 10693687.